March 30th, 2023
Service Delivery Logs for Individualized Skills and Socialization
As of March 14th, 2023, information from the HHSC ISS SDL website page:
Form 8615, On-site and Off-site Individualized Skills and Socialization Service Delivery Log, and Form 8616, In-Home Individualized Skills and Socialization Service Delivery Log, are no longer mandatory to document a service claim of on-site, off-site, or in-home individualized skills and socialization.
A program provider may develop their own service delivery logs or use an electronic health record system to document individualized skills and socialization. All elements from Form 8615 and Form 8616 must be included in any documentation developed.
For each service event the service delivery log must include the following elements:
- Individual’s name
- Name of the individualized skills and socialization provider
- Individualized skills and socialization Provider License Number
- Date of service
- Time in and time out for each service event
- Description of billable activities
- Name and signature of service provider
For off-site service delivery logs, in addition to the information above for each service event, the elements that must be documented include:
- Individual’s level of need (LON)
- Ratio or approved enhanced staff rate
- Number of individuals being served by the service provider during the service event
- Name and address of community location(s) visited during the off-site service event
- Name and signature of the service provider
For in-home service delivery logs, in addition to the information for each service event, the elements that must be documented include:
- Staff ID as assigned by the program provider (meaning the HCS/TxHmL program provider)
HHSC will update Form 8615 and Form 8616 to provide Spanish-language versions. Any submission of forms containing information that is not in English will need to comply with 26 TAC §263.7.
For providers who use Form 8615 and Form 8616, HHSC has provided clarification below:
Form 8616 and Form 8615 are only required to document service events for individuals in the HCS and TxHmL Programs. (Does not include DBMD program)
In the off-site section of the form:
- “Ratio” refers to the ratio for the individual as required by 26 TAC §263.2017 (HCS) or 26 TAC §262.917 (TxHmL).
- “Staff” would equal one.
- “Individuals” refers to the total number of individuals or other persons receiving services assigned to a service provider during a service event. This does not include any identifying information. *Persons outside of the HCS and TxHmL Programs, receiving a similar service, must be included in the number of individuals for the delivery of off-site individualized skills and socialization.
Form 8615 and Form 8616 were developed to document a service event for on-site, off-site, or in-home individualized skills and socialization. Program providers may request additional information or documentation from an individualized skills and socialization provider to obtain updates on the progress or lack of progress towards an individual’s goals.
The days of the week included on Form 8615 and Form 8616 may be altered if an individual receives individualized skills and socialization on a Sunday or Saturday. The program provider must ensure that an individual does not exceed the service limit of five days per calendar week (Sunday–Saturday).
Each service event must have an exact time in and time out and all documented elements. The total amount of time providing the service each day cannot be combined into one service event for that date.
If a program provider chooses to complete Form 8615 or Form 8616 electronically, it must be in compliance with 40 TAC §49.305(j) related to a contractor using electronic records.
For questions about this alert or the service delivery logs for individualized skills and socialization, email HCSPolicy@hhs.texas.gov.
March 1st, 2023
ISS Service Delivery Logs (SDL’s) & Electronic Health Record (EHR) systems
February 21st, 2023
Service Delivery Logs Finally Available for Individualized Socialization Skills Services
INSTRUCTIONS: Updated: 2/2023
Form 8615 is used by Texas Health and Human Services Commission (HHSC) staff, as well as Home and Community-based Services (HCS) and Texas Home Living Service (TxHmL) Waiver program providers to document a service event for on-site and off-site individualized skills and socialization.
When to Prepare
Form 8615 must be completed within 14 calendar days after the activity being documented is provided.
The program provider must maintain a copy of the completed Form 8615 in the individual’s record.
Form 8615 must be used for only one individual.
Form 8615 may be used for multiple billable service events. Each billable service event must have a begin and end time.
Form 8615 is considered a Medicaid document used for Medicaid purposes. By using this form, you understand it is your responsibility to record accurate information, as this information may be subject to a court of law. Failure to record accurate information or deliberate falsification of documentation is strictly prohibited.